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AP Exam 2 > Anesthesia and Surgical Complications > Flashcards

Anesthesia and Surgical Complications Flashcards

1
Q

If we can’t intubate and can’t ventilate what do you NOT do?

A

do not give paralytic until you can verify ability to ventilate

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2
Q

If you cannot ventilate the patient,

A

insert LMA

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3
Q

Conditions necessitating continued intubation:

  • E
  • E
  • R
  • H
  • B
  • O
A
  • epiglottitis
  • localized edema
  • recurrent laryngeal nerve damage
  • hemodynamic instability
  • bleeding
  • prolonged obtundation (anesthetics, metabolic abnormalities, neuro injury)
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4
Q

respiratory problems occur in________

airway obstruction
hypoventilation
hypoxemia

A

PACU:

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5
Q

Airway obstruction causes (7)

  • P
  • S
  • L
  • G
  • V
  • B
  • P
A
  • posterior displacement of tongue
  • secretions
  • laryngospasm
  • glottic edema
  • vomitus
  • blood in airway
  • external pressure on trachea
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6
Q

Corrective measures for air obstructions:

A

oxygen supplementation

jaw thrust, head tilt

NAW preferred, OAW

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7
Q

If obstruction still exists consider what is happening?

A

laryngospasm

PPV and jaw thrust

0.1 mg/kg or 10-20 mg of Succx

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8
Q

If PaCO2 > 45mmHg consider what is happening?

A

hypoventilation

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9
Q

A significant value for PaCO2 >____ mmHg or pH is < ______.

Primary cause for hypoventilation is:

A

60 mmHg

7.25

too many narcotics, patients don’t want to breath

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10
Q

Signs of hypoventilation:

  • S
  • A
  • R
  • T
  • L
A
  • somnolence
  • airway obstruction
  • slow RR
  • tachypnea with shallow breathing
  • labored breathing
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11
Q

Respiratory acidosis = (2)

Cardiac irritability = (1)

A

HTN, tachypnea

cardiac depression

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12
Q

Hypoventilatin is most common respiratory problem in PACU. true or false.

A

true

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13
Q

Signs of residual paralysis:

A

discoordinated movements

shallow TV

tachypnea

head lift < 5 secs

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14
Q

Hypoventilation due to splinting due to pain may be caused from:

A

from upper/lower GI Sx

abdominal distension

tight dressings

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15
Q

Cons of opioid antagonists to treat hypoventilation:

A
  • pain
  • HTN crisis
  • pulmonary edema
  • myocardial infarction/ischemia
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16
Q
  • restlessness
  • tachycardia

cardiac irritability early signs

A

Signs of hypoxia, PaO2 < 60 mmHg

17
Q

Signs of hypoxia: late signs:

A

obtunded (comatose)

bradycardia

hypotension

cardiac arrest

18
Q

Hypoxia due to:

A
  • hypoventilation
  • R-L shunting (blood going from r–>l of heart without being oxygenated)
  • intrapulmonary shunting from decreased FRC due to GA
19
Q

Intrapulmonary shunting can occur (3)

A
  • pulmonary atelectasis caused by insufficient TV delivery
  • parenchymal infiltrates aka pulmonary edema
  • pneumothorax aka lung collapse
20
Q

Cause of intrapulmonary shunting:

A
  • prolonged hypoventilation
  • endobronchial intubation (tube in too deep)
  • pulmonary aspiration
  • pulmonary edema
21
Q

If x-ray is white, means lung is ________.

A

unventilated

More than likelly fluid is built up in the lung cavity.

22
Q

The carina is normally at the T_-T__ level.

A

T5-T7

23
Q

Hypoxia treatment involves:

A
  • 100% O2 nonrebreathing mask or ETT
  • diuretics for fluid overlad
  • brochodilators for bronchospasms
  • PEEP/CPAP for atelectasis
24
Q

Most GI complications involve:

A
  • autonomic afferents from GI mediastinum
  • vestibular CN 8
  • visual//cortical stimuli
  • chemoreceptor trigger zone
25
Q

Most common circulatory complications in PACU:

A
  • hypotension
  • hypertension
  • arrhythmias
26
Q

Always consider possibility of circulatory abnormalities from respiratory disturbances. True or false?

A

true

27
Q

Concerned with BP >= ___ baseline reduction

A

30%

28
Q

What are causes of hypotension?

A

decreased venous return–hypothermic venoconstriction, hypovolemia, third spacing, post op blood loss

LV dysfunction–pneumothorax, cardiac tamponade, fluid overload, CAD, valvular disease

Excessive arterial vasodilatation–neuraxial procedures, adrenergic blockade venodilators, sepsis, allergic reaction

29
Q

Hypertension primary causes: (3)

A
  • noxious stimuli
  • endotracheal intubation
  • bladder distension
30
Q

hypoxemia
hypercapnea
metabolic acidosis
elevated CVP
vascular volume overload

A
  • Secondary causes of hypertension: (5)
31
Q
  • look at ST indicates ischemia
  • respiratory disturbances, hypoxemia, hypercarbia, and acidosis
  • residual effects of anesthetics
A

Arrhythmias

32
Q

Abnormal EKG requiring treatment:

A
  • ventricular tachycardia
  • vent fib
  • Sinus brady/asystole
  • ST with hemodynamic instability

AP Exam 2 (5 decks)

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